scholarly journals Penetrating injury from interpersonal violence and related haemorrhagic shock resuscitation practices in an urban South African emergency medical service

2021 ◽  
Vol 18 ◽  
Author(s):  
Mustafa Zalgaonker ◽  
Navindhra Naidoo ◽  
Lloyd Denzil Christopher
Keyword(s):  
Emergency Medical Service ◽  
South African ◽  
Emergency Care ◽  
Medical Service ◽  
Penetrating Trauma ◽  
Haemorrhagic Shock ◽  
Penetrating Injury ◽  
Intravenous Fluid ◽  
Care Providers ◽  
Emergency Medical

Introduction Physical injury is a major cause of premature death and/or disability worldwide. South African mortality statistics indicate approximately half of all injury-related deaths were intentional, often from sharp-force injuries. Injury surveillance data for victims of penetrating injury is scarce in low- to middle-income countries with a reliance on mortality data. The aim was to provide an epidemiological description of penetrating injury and the related haemorrhagic shock resuscitation practice in a South African emergency medical service. Methods A prospective, observational, descriptive study was conducted in urban Cape Town. ‘R’ statistical computing was used. Emergency care providers voluntarily documented parameters for mechanism of injury, vital signs, intravenous fluid resuscitation and demographic information for patients with penetrating injury. Results Of 2884 (N) penetrating trauma cases, 143 (n) cases were sampled from providers. The chest (35.7%) and upper-limbs (31.5%) were the most common anatomy for penetrating injuries. The estimated mean crystalloid fluid volume administered for penetrating abdominal and chest injuries was 1010.6 mL and 925.3 mL respectively. A statistically significant association was observed between fluid administration and clinical indications such as systolic and diastolic blood pressure, heart rate, capillary refill time, level of consciousness estimation from the scene of the incident to the hospital after intravenous fluid administration. Most emergency medical service call outs (56%) were likely to occur between 20:00 and 02:00. Conclusion The intravenous fluid management by pre-hospital emergency care providers for patients with penetrating traumatic injuries, do not cohere with hypotensive resuscitative recommendations. Future research must include clinical practice guideline implementation efficacy and pre-hospital surveillance mechanisms. This study informs hospital clinician expectations for penetrating trauma care by pre-hospital providers.

scholarly journals The Danish prehospital emergency healthcare system and research possibilities

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Tim Alex Lindskou ◽  
Søren Mikkelsen ◽  
Erika Frischknecht Christensen ◽  
Poul Anders Hansen ◽  
Gitte Jørgensen ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Record ◽  
Healthcare System ◽  
Emergency Care ◽  
Medical Service ◽  
Medical Services ◽  
Emergency Medical Service System ◽  
Emergency Medical ◽  
Medical Healthcare

Abstract The emergency medical healthcare system outside hospital varies greatly across the globe - even within the western world. Within the last ten years, the demand for emergency medical service systems has increased, and the Danish emergency medical service system has undergone major changes. Therefore, we aimed to provide an updated description of the current Danish prehospital medical healthcare system. Since 2007, Denmark has been divided into five regions each responsible for health services, including the prehospital services. Each region may contract their own ambulance service providers. The Danish emergency medical services in general include ambulances, rapid response vehicles, mobile emergency care units and helicopter emergency medical services. All calls to the national emergency number, 1-1-2, are answered by the police, or the Copenhagen fire brigade, and since 2011 forwarded to an Emergency Medical Coordination Centre when the call relates to medical issues. At the Emergency Medical Coordination Centre, healthcare personnel assess the situation guided by the Danish Index for Emergency Care and determine the level of urgency of the situation, while technical personnel dispatch the appropriate medical emergency vehicles. In Denmark, all healthcare services, including emergency medical services are publicly funded and free of charge. In addition to emergency calls, other medical services are available for less urgent health problems around the clock. Prehospital personnel have since 2015 utilized a nationwide electronic prehospital medical record. The use of this prehospital medical record combined with Denmark’s extensive registries, linkable by the unique civil registration number, enables new and unique possibilities to do high quality prehospital research, with complete patient follow-up.

scholarly journals Evaluation of Violence and its Management Experienced by Emergency Medical Service Workers in Lithuania’s Biggest Cities

2020 ◽  
Vol 1 (15) ◽  
Author(s):  
Renata Neniškytė ◽  
Viktorija Grigaliūnienė
Keyword(s):  
Emergency Medical Service ◽  
Medical Service ◽  
Service Providers ◽  
Quality Care ◽  
Medical Personnel ◽  
Healthcare Sector ◽  
Care Providers ◽  
Service Workers ◽  
Emergency Medical ◽  
Violence In The Workplace

The purpose was to investigate violence experienced in work environment by emergency medical service workers of Lithuania’s biggest cities and methods of violence management.Methods – Questionnaire survey.Relevance of the research.  Violence and aggression in the workplace affect many fields and workers of different levels. However, healthcare sector has the highest risk of experiencing violence. In recent years, it was found that healthcare specialists were under substantial risk of experiencing violence from patients or their companions and it raises concern about the medical personnel. Although workers may experience violence and aggression in every healthcare field, it is more likely for the specialists providing emergency medical aid. Therefore, it is of great importance to put efforts into protecting emergency care providers and patients from incidents of aggression or violence in order to deliver quality care for the patients. The objective of this study was to explore violence in the workplace experienced by Lithuania’s biggest cities emergency medical service workers and ways it can be managed.Research results and conclusions. After the analysis of the survey results it was found that emergency medical service workers of Lithuania’s biggest cities most frequently experience violence in form of verbal aggression (on average 57 times a year), provocative aggressive behaviours (22 times a year) and threats (20 times a year). The rarest form of violence experienced was sexual harassment.After analysing the responses, it was noted that emergency medical service providers of Lithuania’s biggest cities experienced violence from patients in more than half of all cases and in about one third of cases of violence it was received from relatives. It should also be noted that a small part (one-tenth of all cases) of violence was received from colleagues at work.In situations of violence, emergency medical service workers try to hide their fear and do not retreat, they remain close to the exit door and try to reduce excessive triggers and noises that could escalate frustration.Keywords: violence, ambulance, aggression. 

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